Varicocele is the most common correctable cause of male infertility, present in up to 40% of men who struggle to father a child. Yet it is often overlooked or left untreated. Dr. Kalpesh Kapadia, MCh Uroandrologist and Gold Medallist from B.J. Medical College, Ahmedabad, offers microsurgical varicocelectomy — the most effective and least invasive treatment for varicocele.

Treating a varicocele can significantly improve sperm count, motility, and the chances of natural conception.

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What is a Varicocele?

A varicocele is an enlargement of the veins within the scrotum — similar to varicose veins in the leg. These dilated veins allow warm blood to pool around the testicle, raising its temperature above the optimal level for sperm production (which requires 2–3°C below body temperature).

Varicoceles are found in approximately 15% of all men and in 35–40% of men investigated for infertility. They occur most commonly on the left side, though they can be bilateral.

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Symptoms

Many men with varicocele have no symptoms at all. When symptoms are present, they may include:

• A dull ache or dragging sensation in the scrotum, especially after standing or physical activity
• Visible or palpable enlarged veins in the scrotum (described as a “bag of worms”)
• Testicular discomfort that worsens through the day
• Reduced testicular size on the affected side
• Abnormal semen parameters (low count, poor motility, abnormal morphology)

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How Does Varicocele Affect Fertility?

The elevated scrotal temperature caused by varicocele damages sperm in several ways:

• Reduces sperm production (low count or oligospermia)
• Damages sperm motility (sperm swim poorly)
• Increases DNA fragmentation in sperm (affecting fertilisation and embryo quality)
• Can cause progressive testicular damage over time if untreated

Importantly, varicocele repair has been shown in multiple studies to improve semen parameters in 60–80% of men, and spontaneous pregnancy rates improve significantly after successful treatment.

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Diagnosis

Dr. Kalpesh Kapadia diagnoses varicocele through:

• Physical examination — grading of varicocele (Grade 1, 2, or 3) by palpation at rest and during Valsalva manoeuvre
• Scrotal Doppler ultrasound — confirms diagnosis, identifies subclinical varicoceles, and measures venous reflux
• Semen analysis — assesses the impact on sperm parameters
• Hormonal tests — FSH, LH, testosterone to assess testicular function

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Treatment: Microsurgical Varicocelectomy

The treatment of choice is microsurgical subinguinal varicocelectomy — performed under magnification using a surgical microscope. This approach allows Dr. Kalpesh Kapadia to:

• Precisely identify and ligate (tie off) all abnormal veins
• Preserve the testicular artery, lymphatics, and vas deferens
• Minimise the risk of recurrence and post-operative complications

The procedure is performed as a day surgery under local or spinal anaesthesia through a small incision. Most men return to work within 3–5 days and to normal physical activity within 2 weeks.

Semen parameters typically begin to improve within 3 months, with maximum improvement seen at 6–9 months after surgery.

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Why Choose Dr. Kalpesh Kapadia?

• MCh (Genitourinary Surgery) — Gold Medallist, B.J. Medical College, Ahmedabad
• Specialist in microsurgical varicocelectomy with operating microscope
• Comprehensive fertility workup to confirm varicocele as the treatable cause
• Post-operative semen analysis and follow-up included
• Works alongside IVF specialists when combined treatment is needed

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Frequently Asked Questions

Should every varicocele be treated?

No. Treatment is recommended when the varicocele is associated with abnormal semen parameters, infertility, testicular pain, or testicular atrophy. An asymptomatic varicocele with normal semen analysis in a man not trying to conceive may simply be monitored.

How long after surgery can we try for a baby?

Sperm take approximately 72 days to mature, so improvements in semen analysis are typically seen from 3 months after surgery. Most couples are advised to try naturally for 6–9 months post-surgery before considering assisted reproduction.

Is varicocele surgery painful?

The procedure is performed under anaesthesia, so there is no pain during surgery. Post-operative discomfort is mild and well managed with standard pain relief. Most men are comfortable within a few days.

Can varicocele come back after surgery?

Recurrence rates with microsurgical varicocelectomy are very low — approximately 1–2% — significantly lower than with open or laparoscopic approaches.

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Book a Consultation

If you have been told you have a varicocele, or if you are struggling with male infertility and want a complete evaluation, Dr. Kalpesh Kapadia can provide expert assessment and a clear treatment plan.

📞 Call or WhatsApp: +91 99984 78633
📧 Email: ahmedabadandrology@gmail.com
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